NPH Awareness Are you, or anyone you know, over sixty years old and experiencing the following? l
Difficulty walking - as though your feet are stuck to the floor?
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Trouble with balance?
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Having some falls?
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Getting confused?
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Forgetful?
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Losing interest in things?
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Maybe not getting to the toilet in time?
Please don’t assume this is all part of growing older. It might be a little-known condition called NPH Normal Pressure Hydrocephalus. So, please do tell your GP about your symptoms and show them this leaflet.
Information to show your doctor What is NPH ? Cerebrospinal fluid [CSF] is produced continually in the ventricles [cavities] of the brain. Under normal conditions CSF circulates through the brain acting as a protective cushion and providing nutrients. NPH (Normal Pressure Hydrocephalus) results when the flow of fluid is blocked in some way causing an abnormal amount of CSF to accumulate in the ventricles, which, in turn, enlarge, affecting the function of the surrounding brain. It occurs most often in people aged over 60.
What are the symptoms of NPH ? The three main symptoms of NPH are mobility problems, some dementia and urinary incontinence. Dementia will include short term memory loss, forgetfulness and difficulty in dealing with everyday tasks. Because these symptoms appear gradually and are commonly associated
with old age, many people think they are normal and assume they must learn to live with their problems. Mobility problems may include shuffling or walking with a wide based gait. People with NPH may feel very unbalanced when walking, particular when turning, resulting in frequent falls. Urinary incontinence is usually the last symptom to appear, often starting when someone has difficulty getting to the toilet in time.
What causes NPH ? For most patients the cause is unknown.
How is it diagnosed ? Diagnosis is difficult due to some of the symptoms being similar to other disorders, e.g. Alzheimer’s, Parkinson’s Disease or simply increasing age. Many cases go completely unrecognised and are never treated. A GP should consider referring patients with the main symptoms (dementia accompanied by gait disturbance and in some cases, urinary incontinence) to a neurologist or neurosurgeon or geriatrician who can investigate further. If NPH is diagnosed, treatment to alleviate the symptoms may be possible.
This leaflet has been produced by the Association for Spina Bifida and Hydrocephalus (ASBAH). You can find out more about NPH (Normal Pressure Hydrocephalus) on our charity’s website www.asbah.org or phone ASBAH on 01733 555988. We would like to thank the North Bristol NHS Trust, Codman and the Bristol School of Animation at the University of the West of England for their help in our work to raise awareness of NPH.
Registered Charity No 249338
Illustrations by Susan Elliott